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The Political Economy of Education and Health Service Delivery in Afghanistan

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The Political Economy of Education and Health Service Delivery in Afghanistan The Political Economy Of Education and Health Service Delivery In Afghanistan January 2016 Afghanistan Research and Evaluation Unit Issues Paper The Political Economy Of Education and Health Service Delivery In Afghanistan AREU January 2016 ISBN: 978-9936-8044-5-6 (ebook) Editing: Victoria Grace Cover photos (Top to bottom): Child receives polio drops as part of the campaign to immunise children under the age of five. Girls and boys playing in school playground. Students checking their result sheets. Doctors from the orthopaedic section of Wazir Akbar Khan Hospital visiting the patients. (Photos by Gulbudding Elham) AREU Publication Code: 1517E This publication may be quoted, cited, or reproduced only for non-commercial purposes and provided that the source is acknowledged. The opinions expessed in this publication are those of the contributors and do not necessarily reflect those of the World Bank or Afghanistan Research and Evaluation Unit. Where this publication is reproduced, stored, or transmitted electronically, a link to AREU’s website (www.areu.org.af) should be provided. Afghanistan Research and Evaluation Unit 2016 About the Afghanistan Research and Evaluation Unit The Afghanistan Research and Evaluation Unit (AREU) is an independent research institute based in Kabul. AREU’s mission is to inform and influence policy and practice by conducting high-quality, policy-relevant research and actively disseminating the results, and by promoting a culture of research and learning. To achieve its mission AREU engages with policymakers, civil society, researchers and students to promote their use of AREU’s research and its library, to strengthen their research capacity, and to create opportunities for analysis, reflection, and debate. AREU was established in 2002 by the assistance community in Afghanistan and has a Board of Directors comprised of representatives of donor organisations, the United Nations and other multilateral agencies, and non-governmental organisations. Specific projects in 2015 were funded by the European Commission (EC), the Swiss Agency for Development and Cooperation (SDC), the Overseas Development Institute (ODI), the World Bank, Security Governance Group (SGG), United States Institute of Peace (USIP), the Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ) GmbH, the Embassy of Finland, International Maize and Wheat Improvement Centre (CIMMYT), Leveraging Agriculture for Nutrition in South Asia (LANSA), School of Oriental and African Studies (SOAS) and Netherlands Organisations for Scientific Reseach (NWO). The Political Economy Of Education and Health Service Delivery In Afghanistan iii 2016 Afghanistan Research and Evaluation Unit Acknowledgements The following AREU field researchers carried out the focus-group discussions and in-depth interviews: Mujib Ahmad Azizi and Shukria Azadmanesh (Senior Research Assistants); Khalid Behzad, Freshta Nehad, Mujeeb Behsoodi, and Ahmad Noorzai (Research Assistants); Mansoor Mamoodi and Asif Nazari (Research Interns); Sabawoon Khanzada (Security Officer). The Organisation for Sustainable Development and Research field team gathered the data in Wardak province. Jennefer Lyn Bagaporo led the team during fieldwork and data processing as well as for the initial analysis, and wrote the first draft of the paper. Nader Nadery and Antonio Giustozzi reviewed the drafts and contributed valuable inputs to the writing of the final paper. The World Bank Task Team was led by Richard Hogg, Programme Leader Governance and Service Delivery; Simon Carl O’Meally, Governance Specialist/Joint Task Team Leader; Jonathan di John, Consultant; Aditi Nishikant Hate, Task Team Focal Point—all provided valuable research methodology and framework guidance, comments, data, and reading materials to improve the paper. Mithila Suresh Deshpande helped in sending World Bank project documents to the research team. Michael Lou Montejo contributed to the maps, cover design, and draft layout of the paper. Above all, we acknowledge the informants and participants from the Ministry of Education and the Ministry of Public Health, programme implementers of SHARP and EQUIP from national, provincial, district, and community levels, and implementing partners who provided input and insights during the interviews; the community members, officials, and community stakeholders in the study areas who accommodated the research team’s endless questions with candidness and patience, and opened up issues about the implementation of both programmes. The study is part of a wider World Bank regional study, covering Afghanistan, Pakistan and Nepal, examining the relationship between service delivery and conflict. A synthesis report of all three country case studies will be published in 2016. The study is funded by the World Bank-Australia “Partnership for South Asia” Trust Fund and the World Bank-Korea “Trust Fund to Support Economic and Peace Building Transitions” funded by the Australian and Korean governments, respectively. We would like to thank both governments for their generous support. Chona R. Echavez January 2016 iv AREU Afghanistan Research and Evaluation Unit 2016 Table of Contents 1. Introduction .............................................................................................4 2. The Status of Service Delivery in Afghanistan: An Overview of the Education and Health Sectors ...................................................................................................7 2.1 General description of education and health service delivery in Afghanistan ......7 2.2 Education delivery in the three case study provinces ................................ 10 2.2.1 Support for education ........................................................ 10 2.2.2 Data and performance comparison ......................................... 12 2.2.3 Support for health services .................................................. 16 2.2.4 Data and performance comparison ......................................... 18 3. Violence and Political Settlements in Afghanistan .............................................. 23 3.1 The primary political settlement ........................................................ 23 3.2 The security outlook of the three provinces ........................................... 25 3.3 The politics of education delivery ....................................................... 29 3.4 The politics of health services delivery................................................. 31 4. Case Study 1: Wardak Province .................................................................... 33 4.1 Overview of Wardak Province ............................................................ 33 4.2 History and nature of the violence in Wardak ......................................... 34 4.3 The local and provincial elites and their interactions ................................ 35 4.4 The politics of education service delivery in Wardak ................................ 36 4.4.1 Sectoral elite bargains ....................................................... 36 4.4.2 The impact of secondary settlements on education ..................... 39 4.4.3 Impact on EQUIP and adaptation ........................................... 40 4.5 The politics of health service delivery in Wardak ..................................... 40 4.5.1 Sectoral bargains .............................................................. 40 4.5.2 The impact of secondary settlements on health services .............. 42 4.5.3 Impact on SHARP and adaptation ........................................... 42 4.6 Conclusion ................................................................................... 43 5. Case Study 2: Badghis Province .................................................................... 44 5.1 Overview of Badghis Province ............................................................ 44 5.2 History and nature of the violence in Badghis Province .............................. 45 5.3 The local and provincial elites and their interactions ................................ 46 5.4 The politics of education service delivery in Badghis ................................ 49 5.4.1 Sectoral elite bargains ....................................................... 49 5.4.2 The impact of secondary settlements on education ..................... 51 5.4.3 Impact on EQUIP and adaptation ........................................... 52 5.5 The politics of health service delivery in Badghis .................................... 52 5.5.1 The impact of the primary settlement .................................... 52 5.5.2 Sectoral elite bargains ....................................................... 53 5.5.3 The impact of secondary elite bargains ................................... 54 5.5.4 The impact on SHARP and its adaptation ................................. 55 5.6 Conclusion ................................................................................... 55 6. Case Study 3: Balkh Province ....................................................................... 56 6.1 Overview of Balkh Province ............................................................... 56 6.2 History and nature of the violence in Balkh ........................................... 57 6.3 The economic and political powerholders and their interactions .................. 57 6.4 The politics of education service delivery in Balkh ................................... 59 6.4.1 The impact of the secondary settlement .................................. 59 6.4.2 Sectoral elite bargains ......................................................
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